Coastline Neuropsychiatric - Medicare Mental Health Clinic in Pensacola, FL

Coastline Neuropsychiatric is a medicare enrolled mental health clinic (Clinical Neuropsychologist) in Pensacola, Florida. The current practice location for Coastline Neuropsychiatric is 890 S Palafox St Suite 300-l, Pensacola, Florida. For appointments, you can reach them via phone at (850) 341-4896. The mailing address for Coastline Neuropsychiatric is 304 W Gadsden St, Pensacola, Florida and phone number is (850) 341-4896.

Coastline Neuropsychiatric is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1043996986. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (850) 341-4896.

Contact Information

Coastline Neuropsychiatric
890 S Palafox St Suite 300-l
Pensacola
FL 32502
(850) 341-4896
(850) 433-1996

Mental Health Clinic Profile

Full NameCoastline Neuropsychiatric
SpecialityClinical Neuropsychologist
Location890 S Palafox St Suite 300-l, Pensacola, Florida
Authorized Official Name and PositionKevin Neil Groom (OWNER)
Authorized Official Contact8503414896
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Coastline Neuropsychiatric
304 W Gadsden St
Pensacola
FL 32501

Ph: (850) 341-4896
Coastline Neuropsychiatric
890 S Palafox St Suite 300-l
Pensacola
FL 32502

Ph: (850) 341-4896

NPI Details:

NPI Number1043996986
Provider Enumeration Date06/26/2023
Last Update Date10/06/2023
Certification Date10/06/2023

Medicare PECOS Information:

Medicare PECOS PAC ID4284089061
Medicare Enrollment IDO20231013002536

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Medical Identifiers

Medical identifiers for Coastline Neuropsychiatric such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043996986NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103G00000XClinical Neuropsychologist (* (Not Available))Primary
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Coastline Neuropsychiatric acts as a billing entity for following providers:
Provider NameKevin N Groom
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1184717027
PECOS PAC ID: 3072417807
Enrollment ID: I20070515000582

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Provider NameCris W Jagar
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1538269121
PECOS PAC ID: 9830126820
Enrollment ID: I20130717000718

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